Inappropriate Client Relationships

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Pardon the interruption from the five culture bolsters of which I will complete with the next blog. But I was recently accused of having inappropriate relationships with my clients and this has haunted me for weeks. I felt compelled to pause and write about it. Before we go any further, two things: one, this has nothing to do with sex and two, this was an accusation by one of my most favorite people and my previous colleague. It was not out of malice by any means that she said these words to me and it took time before I could fully grasp the comment. At the moment, I simply agreed with her. I did allow clients to become friends and family. I loved them dearly and I spent an enormous amount of time in the exam room each and every time learning about them as people so that I could help them. The more information I could collect, the better equipped I felt I was to treat their pet. 

They understood and trusted that I cared, that I was making the best possible decisions regarding the healthcare of their pet, and that I wasn’t perfect but I was dedicated. I often allowed clients to return items that potentially I shouldn’t have, giving them full refunds because I knew their financial situation and infuriating my hospital manager. They had my email address and emailed over the weekends. I would travel to their homes for euthanasia. I was invited to their weddings and celebrations. I would bend rules for certain clients making it impossible for the staff to understand which client could do what in the hospital. 

We have moved far away from the medicine of the past, the doctors that carry a black bag and go into the homes of their patients to visit with them, treat them, celebrate with them and grieve with them. To me, this is not inappropriate and speaks to what we have lost in our fast-paced society. Rooms are scheduled down to fifteen minutes so that the hospital can turn the profit they seek. Doctors never receive the lunch break they need because the workload is staggering. We can hardly get a full history from our clients before it is time to move on to the next. I am an old soul that wants to carry the black bag into the exam room and sit and visit and learn. 

So is this an inappropriate relationship with my client? Not for me. It is the only way I know how to exist as a doctor. But my dearest friend was not wrong with her accusation because she was in the practice with me. It wasn’t her dream to have these client interactions, but I had created an environment in which it was the clients’ expectations. This was my vision for my practice, my mission statement. It wasn’t hers and I completely exhausted her. Her vision of a clinic is more of a quick in and out with a treatment plan. Does this make her any less of a doctor than me? Absolutely not. She is an incredible doctor and person. We just have different visions of how we want to practice medicine. Does this make my desire to form these relationships with clients inappropriate? No. It is just the way I want to practice medicine. 

The larger I grew the hospital, the further I got from my vision and the more unhappy I felt coming to work. I had surrounded myself with brilliant doctors that did not want to have the same relationships that I had with my clients. I understand this now looking back and wish I could have navigated this situation more skillfully. Perhaps I should have just stayed a very small clinic so that my vision could remain my vision. The doctors at my former hospital are continuing to practice amazing medicine, saving lives every day, but the farther along I got in their vision, the more frustrated I became. I was simply outnumbered with the new direction of the hospital and I failed to communicate properly because I didn’t yet understand why. 

My hospital manager at the time was a hell of a manager, but not for what I envisioned for my hospital. She is the quintessential manager for a corporate run practice where rules are rules and there is little gray area. This is her comfort zone and where she thrives. My constant changing and bending the rules for certain clients drove her mad. And that is perfectly ok. Just like it is perfectly acceptable for my colleagues to be frustrated by what they felt were my inappropriate relationships with clients. It just wasn’t their vision. 

So what is the point of this blog? It occurred to me as I was mulling this over for weeks, that maybe one of the reasons we get so fatigued is that we are not aware of what boundaries we want set for ourselves with clients. What are your boundaries? What type of relationships do you want with your clients? I propose that maybe we are not taking enough time to learn who we are as doctors before we enter into a practice. We simply take a job based on the appearance of how we think they practice medicine or how the practice looks or maybe because we respect someone at the practice. But does the clinic where you are working parallel with the boundaries that you have set for yourself? If you don’t want to get involved in the emotional roller coaster of clients, are you working at a fast-paced clinic that promotes this? 

Better yet, maybe you do want these client bonds and cannot seem to find a place where you fit in. Is it time for you to start your own practice? Perhaps this is how the vision of corporate veterinary clinics versus mom and pop shops balance. When the market was so hot and corporations were gobbling up every single clinic they could get their hands on, I was left wondering what the future of veterinary medicine looked like. While writing this blog, it has become clearer to me. 

There will be the giant clinics that are corporate run that are more fast-paced. They are more turn and burn and are incredibly important parts of our work. This is not to belittle corporate veterinary clinics, but to just simply have them fill a space that is needed. Then there will be the very small clinics that continue to be run by the doctor that choose to stay small to maintain their mission. We need these places too. 

I am rounding the corner on a two year hiatus from practicing veterinary medicine. And I am deeply grateful for the time that I got to reflect on what actually happened to me at my practice. Why one day I woke up and could not for the life of me stay any longer. I all but ran from the practice to save myself. And in the dust were hurt employees whom I adored. I gave little explanation because I actually didn’t know why I had to leave but I could not physically go on for another moment. I have spent these two years processing the guilt and I have forgiven myself. And as for those hurt employees, I hope they will one day forgive me too. 

Now it is time for me to step back into practice and open another veterinary hospital. But this time I will be armed with my list of client boundaries and my mission statement. I will know what this hospital will look like and I will not deviate from the vision and the purpose. I will not hire employees unless their vision aligns with mine. But in order for this to happen, I have to take the time to understand fully what that means. It was never a question that I asked interviewees. I never even entertained the idea. But truly, how can we expect them to want to stay with us if we are not aligned in our purpose and our path to get there? Simply practicing great medicine is not enough as I once thought it was. We have to craft the questions to ascertain if the employer and employee visions align. Then we can nurture those relationships through training. In so doing, we are less likely to fatigue our wonderful teammates and ourselves. 

Find me on The Veterinary Compassion Fatigue Project Spotify Podcast, my website, Facebook and YouTube @TVCFP. Let’s keep talking about what we face in the veterinary and animal care world and ways that we can help each other. Reach out if you have a particular topic you would love to hear about. Subscribe to hear updates on our annual restoration retreat to be launched in Spring of 2025. As always, I hope you find what you are looking for and share it with anyone who needs it.

With love and hope,

Dr. Erin Holder